Implementing community based inclusive development for people with disability in Latin America: a mixed methods perspective on prioritized needs and lessons learned.

BACKGROUND: Research on the needs of people with disability is scarce, which promotes inadequate programs. Community Based Inclusive Development interventions aim to promote rights but demand a high level of community participation. This study aimed to identify prioritized needs as well as lessons learned for successful project implementation in different Latin American communities. METHODS: This study was based on a Community Based Inclusive Development project conducted from 2018 to 2021 led by a Columbian team in Columbia, Brazil and Bolivia. Within a sequential mixed methods design, we first retrospectively analyzed the project baseline data and then conducted Focus Group Discussions, together with ratings of community participation levels. Quantitative descriptive and between group analysis of the baseline survey were used to identify and compare sociodemographic characteristics and prioritized needs of participating communities. We conducted qualitative thematic analysis on Focus Group Discussions, using deductive main categories for triangulation: 1) prioritized needs and 2) lessons learned, with subcategories project impact, facilitators, barriers and community participation. Community participation was assessed via spidergrams. Key findings were compared with triangulation protocols. RESULTS: A total of 348 people with disability from 6 urban settings participated in the baseline survey, with a mean age of 37.6 years (SD 23.8). Out of these, 18 participated within the four Focus Group Discussions. Less than half of the survey participants were able to read and calculate (42.0%) and reported knowledge on health care routes (46.0%). Unemployment (87.9%) and inadequate housing (57.8%) were other prioritized needs across countries. Focus Group Discussions revealed needs within health, education, livelihood, social and empowerment domains. Participants highlighted positive project impact in work inclusion, self-esteem and ability for self-advocacy. Facilitators included individual leadership, community networks and previous reputation of participating organizations. Barriers against successful project implementation were inadequate contextualization, lack of resources and on-site support, mostly due to the COVID-19 pandemic. The overall level of community participation was high (mean score 4.0/5) with lower levels in Brazil (3.8/5) and Bolivia (3.2/5). CONCLUSION: People with disability still face significant needs. Community Based Inclusive Development can initiate positive changes, but adequate contextualization and on-site support should be assured.

[Hansen versus Neisser: scientific controversies over the 'discovery' of the bacillus of leprosy]. / Hansen versus Neisser: controvérsias científicas na 'descoberta' do bacilo da lepra.

This paper analyzes the turbulent scientific process that led to the 'discovery' of the bacillus that causes leprosy, which occurred in Europe in the second half of the nineteenth century and which involved some of the leading names in medical science of the period, such as Robert Koch, Rudolf Virchow and Armauer Hansen. Understood as a scientific paradigm, this 'discovery' is reexamined here based on primary sources as yet only partially researched in Latin America. The scope of this paper is to provide new instruments for analysis and reflection for the historiography of the sciences, as the cultural, social and even nationalist aspects are identified in the construction of this paradigm.

Hansen versus Neisser: controvérsias científicas na 'descoberta' do bacilo da lepra / Hansen versus Neisser: scientific controversies over the 'discovery' of the bacillus of leprosy

Analisa o conturbado processo científico que levou à 'descoberta' do bacilo causador da lepra, na Europa, na segunda metade do século XIX, e que envolveu alguns dos principais nomes da ciência médica do período, como Robert Koch, Rudolf Virchow e Armauer Hansen. Compreendida como paradigma científico, tal 'descoberta' será aqui reexaminada historicamente através de fontes primárias ainda pouco trabalhadas na América Latina. Objetiva-se oferecer novos instrumentos de análise e de reflexão para a historiografia das ciências, posto que serão identificados aspectos culturais, sociais e mesmo nacionalistas na construção desse paradigma.

This paper analyzes the turbulent scientific process that led to the 'discovery' of the bacillus that causes leprosy, which occurred in Europe in the second half of the nineteenth century and which involved some of the leading names in medical science of the period, such as Robert Koch, Rudolf Virchow and Armauer Hansen. Understood as a scientific paradigm, this 'discovery' is reexamined here based on primary sources as yet only partially researched in Latin America. The scope of this paper is to provide new instruments for analysis and reflection for the historiography of the sciences, as the cultural, social and even nationalist aspects are identified in the construction of this paradigm.